The Role of Occupations in the Decline of Pulmonary Tuberculosis. Insights From Amsterdam’s Jewish Neighbourhoods, 1856–1909

The decline of pulmonary tuberculosis in the second half of the nineteenth century was instrumental in shaping long-term shifts in historical mortality patterns and life expectancy. Despite its significance, the underlying determinants of this decline remain a subject of ongoing debate. This study contributes to the discussions about the role of standards of living by examining the impact of occupation on the decline of pulmonary tuberculosis mortality in Amsterdam between 1856 and 1909. It does so through the lens of the city’s Jewish neighbourhoods, that, despite facing poverty and overcrowding, exhibited substantially lower tuberculosis mortality rates than the rest of the city, but also experienced a slower decline over time. Using individual-level mortality data from the Amsterdam Causes-of-Death Database and occupational data from marriage certificates, we analyse how shifts in occupational structures following industrialization influenced these trends. Our findings highlight the significant role of labour conditions in shaping historical health disparities and suggest that work environments, alongside nutrition and public health measures, played a pivotal role in shaping and exacerbating intra-urban health disparities.